Active NPI
Mary Elizabeth Crois, PSY.D.
- Psychologist
- Glen Ellyn, IL
National Provider Identifier
1659453579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 331 Phillips Ave
Glen Ellyn, IL 60137-4938 - Phone
- (630) 881-3894
- Fax
- (630) 469-4945
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | IL | Primary |
Addresses
Primary practice location
331 Phillips Ave
Glen Ellyn, IL 60137-4938
Mailing address
331 Phillips Ave
Glen Ellyn, IL 60137-4938
Phone (630) 881-3894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050919000587 | IL | Practitioner - Clinical Psychologist | 9436183530 | Practice locations: Bloomingdale, IL; Chicago, IL; Elgin, IL; Glen Ellyn, IL; Lombard, IL; Wheaton, IL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659453579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 PHILLIPS AVE",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601374938",
"telephone_number": "630-881-3894",
"fax_number": "630-469-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 PHILLIPS AVE",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601374938",
"telephone_number": "630-881-3894",
"fax_number": "630-469-4945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROIS",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Ellyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.